The Los Angeles (LA) PRISMS Center aims to be the leader in the development and application of mobile health (mHealth) technologies that deepen our scientific understanding and clinical management of pediatric conditions. Bringing together leading experts from UCLA and USC in biomedical informatics, computer science, wireless health, environmental science and health, and pediatrics, this Center proposes creation of an innovative end-to-end software infrastructure for pediatric sensor-based health monitoring. Focusing on pediatric asthma, our Center's vision and proposed research is motivated by the following question: what if you could predict ahead of time, for a specific asthma patient, the potential for exacerbation and thus mitigate - if not prevent - the event? Any system with this ability must integrate the growing array of available physiologic and environmental data from sensors, and place such data into context to elucidate the patient's state and specific situation. The system must be able to act sufficiently quickly on sensed data to make timely recommendations, and end user compliance with system usage must be high to effect change. Our solution, the Biomedical REAl-Time Health Evaluation for Pediatric Asthma (BREATHE) platform, provides an extensible framework for the deployment of data collection protocols; secure data collection from sensors to a mobile device; integration of additional contextual information; and real-time analysis. Importantly, usability is a central consideration in the desig of BREATHE, reflected in an iterative design/evaluate/refine process. To build and assess BREATHE, the Center comprises three closely coordinated efforts: Project 1 - Integrated Sensing from the Device to the Cloud, which establishes APIs for automatically gathering information from a device and local sensors, communicating with the anticipated PRISMS U01 sensors and U24 coordinating data center; Project 2 - Integrating and Visualizing Clinical, Environmental, and Sensor Data, which focuses on combining data acquired from the U24 data center with contextual information (e.g., regional air quality, clinical elements from the patient' electronic health record, etc.) with real-time processing and analysis infrastructure; and Project 3 - Real-time Asthma and Air Pollution Project (Asthma APP), which develops a framework for evaluating system performance and real-world field testing of the platform for self-management and early interventions. BREATHE takes advantage of contemporary and open standards for secure networking and device management, mHealth toolkits, and mobile UIs from which open collaboration can occur. Collectively, these Projects' efforts realize BREATHE, changing how we interact with pediatric asthma patients and their caregivers to actuate a better understanding of the disease and improve adherence, and to achieve more personalized medicine through more detailed, objective measurements of an individual's daily activities and surroundings. For research, BREATHE will further enable testing of many hypotheses about environmentally-related chronic pediatric illnesses.